RSIA AGM 13-6-1998
Prof. Howard Bird, Leeds University
Went over the anatomy of shoulder and arm, and the various conditions encompassed by the term RSI. He described a study of workers in a Carlisle biscuit factory. There were 13 female biscuit packers, 12 had RSI. They had been employed for an average of 13 years, on average they had 4 years of symptoms, there was no correlation between length of work and symptoms. There is a relationship between change of working environment and the onset of symptoms. There is progressive onset, the longer you have RSI the longer the period of rest needed, and then eventually rest has no effect. They found impaired grip strength, worse after work, (after correcting for natural change over the day.) His department estimates that 3% of working population has symptoms (8 years ago). They found guitarists are a problem. Also people with mobile joints have a problem as the muscles have to work more to stabilise the joints. Changing musical instruments causes a problem e.g. Oboe to Cor Anglais or Violin to Viola.
Identify the precipitating factors, then remove the factors, modify the work load – may require rest. Job rotation is important as it changes the muscles used. The working environment must be ergonomically sound. The worker must be able to take adequate breaks and take adequate rest at the evenings and weekends. Avoid piece work. In the early stages, stop before the pain starts. Splints may help Work at a position of maximum mechanical advantage.
Treatment of the later stages:
Stretches and hot and cold packs help. Avoid anti-inflammatory. Use pain killers, Paracetamol is the cheapest, but don’t use them to mask the pain and continue working. Locally applied creams are better than anti-inflammatory tablets.
A study of Japanese checkout operators found:
3 years 36% recovered
5 years 64% recovered
10 years 94% recovered
mean 4.5 years after removing precipitating factors.
Sketchly Park (sister to Munsley Park) is trying to get money from the government’s back-to-work scheme to treat RSI type conditions. This funding would be available to people on disability benefit or sickness benefit.
AGM Formal Business
Peter Kilbride is leaving at the end of July, so they are about to advertise for a new director. The grant received from the DSS has been extended from three to five years. The resolution to change the status of the association to a limited company was approved (this is to remove the financial liability of the trustees — the committee members)
Dr. Bruce Lynn, UCL
He started his presentation by saying that one of his students came to him and asked if he knew anything about soft tissue pain in the arm. He realised that he knew very little about this subject. His student suggested some research into the subject. This student was Jane Greening. The research they did was a pilot study to see if it could determine whether people had RSI or not. (Hence the small number of people in the study.) The results were much more conclusive than they had hoped. The main change was in the median nerve. The Office worker group median nerve changes are as marked as the RSI sufferers, in fact most of the Office workers got arm pain at some time. The only group that got worse when they tried typing was the RSI sufferers. They were also hypersensitive to strong stimuli, which often go with lack of sensitivity to normal stimuli.
The vibration test cannot be used for testing for RSI in the individual. The test, shows on average that RSI sufferers have higher vibration thresholds than the normal group and proves that RSI causes nerve damage. But the range for RSI sufferers overlaps the range for the normal group and so cannot be used on an individual basis. Theirs is not the only research (on vibration thresholds) showing these results. In the USA in two separate studies, one ten years ago and one last year showed exactly the same results, but no one made a fuss, even though they were reported in eminent journals. The test ten years ago tested hundreds of people and showed there was nerve damage. He said they were still getting 2-3 phone calls per week about their research. They are getting phone, fax and email from around the world. Pain in the upper limb is a major problem; the hand is the most important part of the body. No other organism has as complex a hand as humans. It is the one part of the human body that has evolved to a more advanced state compared to other organisms.
They are now doing follow-up studies by studying the nerve function of the hand. Is the damage to the nerves just to those that sense vibration or are other nerves affected as well? They are going to look at nerves using MRI and see if they are unusual. They are also going to study young keyboarders for two years to see if they develop RSI. Stress is a big factor in disease. Stress in employment is due to the lack of security of jobs. The best way to overcome this is to reverse all the employment legislation of the past 15 years (Big cheer from the audience). He also felt that no fault compensation should be brought in for insurance. At the press conference given when they announced the results someone asked if the research meant all repetitive work would damage the nerves. He thought for a moment, as this had not occurred to him, and he said YES. In discussion with someone writing for an insurers journal Dr. Lynn said that if their results turned out to be correct then the insurers could face paying out hundreds of millions of pounds in compensation. The only way of avoiding this would be to ensure the companies they insure adopt best practice.
He said: Keep the mouse in front of you.
Jim Marshall, GMB Union
Jim Marshall gave an amusing talk on the union’s approach to health and safety in the workplace and how people’s attitudes to RSI had changed. The GMB union ran a limerick competition after the Judge Prosser ruling, unfortunately none of them were printable! After years of giving press conferences on H&S, the announcement of the vdu regs, drew in a full room of journalists (very unusual), then he realised that the staff on the Financial Times were having a bit of bother with RSI, and journalists, for some reason, had suddenly become interested! He then described the vdu regs and the EU directive that they are implementing and the way they are generally not that well implemented in companies. He then reminded us that Breach of H&S regulations (including vdu regs) is a criminal act with up to two years in jail! (remind your employer of this next time they refuse to buy you new equipment for your workstation) He made the point that EU directives (1993 vdu regs. in particular) take precedence over UK legislation.
New regulations due this year on the rate at which people work which re-inforce the ergonomic regulations. The work must be adapted to the individual. There then followed a question and answer session. Various people congratulated Dr. Lynn on the research. Bunny Martin, who is running the BAC workshop for school children, to educate them on RSI, said that 50% of the children at the workshops had arm pain of some sort.